Földes I, Lévay A
BM Központi Kórház, Budapest.
Orv Hetil. 1994 Jul 17;135(29):1579-84.
Autoantibodies to thyroperoxidase (anti-TPOAb) and thyroglobulin (anti-TgAb) were measured in 564 patients with various thyroid disorders and in 59 healthy subjects using chemiluminometric immunoassay. The frequency of elevated titers was 8.6% in healthy subjects, 76.2% in patients with untreated hyperthyroidism and diffuse goiter, 80.7% in patients with relapse of hyperthyroidism. 83.4% of patient with hyperfunction changed spontaneously to hypothyroidism and 71.5% of patients with hypothyroidism and goiter had antibodies above the normal range. Unexpectedly low prevalence of autoantibodies were detected in patients with primary myxoedema without goiter (48.2%) and in patients with endocrine ophthalmopathy and euthyroidism (33.2%). In the subgroup of patients with hyperthyroidism under methimazole treatment we found an incidence of positivity of 56% and the mean of positive values was lower compared with the untreated ones. In 42.8% of patients with hyperthyroidism and diffuse goiter treated successfully by methimazole, surgery or radioiodine elevated concentrations of antibodies could be detected, however they were in remission for more than five years. 197 (82.4%) of the patients with positive antibody titers showed higher concentrations to peroxidase compared with thyroglobulin. 57.9% of serum samples positive for anti-TPOAb were negative for anti-TgAb, whereas 9.4% of samples positive for anti-TgAb were anti-TPOAb negative. The diagnosis of thyroid autoimmunity could generally be based on measurement of anti-TPOAb with additional measurement of anti-TgAb in special cases.
采用化学发光免疫分析法对564例患有各种甲状腺疾病的患者及59名健康受试者检测了抗甲状腺过氧化物酶自身抗体(抗TPOAb)和抗甲状腺球蛋白自身抗体(抗TgAb)。健康受试者中抗体滴度升高的频率为8.6%,未经治疗的甲状腺功能亢进症和弥漫性甲状腺肿患者中为76.2%,甲状腺功能亢进症复发患者中为80.7%。83.4%的功能亢进患者自发转变为甲状腺功能减退症,71.5%的甲状腺功能减退症和甲状腺肿患者抗体高于正常范围。在无甲状腺肿的原发性黏液性水肿患者(48.2%)和内分泌性眼病且甲状腺功能正常的患者(33.2%)中,检测到的自身抗体患病率意外地低。在接受甲巯咪唑治疗的甲状腺功能亢进症患者亚组中,我们发现阳性发生率为56%,且阳性值的平均值低于未治疗患者。在42.8%经甲巯咪唑、手术或放射性碘成功治疗的甲状腺功能亢进症和弥漫性甲状腺肿患者中,可检测到抗体浓度升高,但他们已缓解超过5年。197例(82.4%)抗体滴度阳性的患者中,抗过氧化物酶的浓度高于抗甲状腺球蛋白。抗TPOAb阳性的血清样本中57.9%抗TgAb阴性,而抗TgAb阳性的样本中9.4%抗TPOAb阴性。甲状腺自身免疫的诊断通常可基于抗TPOAb的检测,特殊情况下需额外检测抗TgAb。